The goal of this R-21 application is to work with the cancer survivorship community to help improve their quality of life. Poverty, low literacy skills and rurality can lead to health disparities in cancer treatment, the ability to survive cancer and the quality of life after treatment is completed. Our aims will help clarify the role of low income and education, and rural residency in the unmet needs of cancer survivors. This proposal was written by researchers and cancer survivors, and we plan to expand our collaborations throughout the two years of implementing this proposal. There are 2 main aims in this proposal. In Aim 1 we will develop a collaborative partnership with the Vermont cancer survivor community that will oversee the planning, implementation and analyzing and reporting of results. As part of Aim 1 we will develop a regional population-based multi-purpose cancer survivor registry that will include both long term and short term survivors. In Aim 2 we will describe the unmet cancer}related needs of cancer survivors in the following areas: treatment;information and decision support;emotional, social and spiritual;physical;activities and logistics of daily living;health and wellness;economic and legal;and navigating service delivery systems. We will describe these needs by the following personal characteristics and history: rural residency, education, income, stage of diagnosis, time since diagnosis, demographics (gender, age), types of treatment (radiation therapy, surgery, chemotherapy), and health insurance. We hypothesize that rural residency, low income and education, older and younger age, shorter time since diagnosis and diagnosis of late-stage disease will each have significant independent effects on the unmet survivorship needs. In addition we will create an environment that engages the community in the research process and agenda. We will develop, collect and analyze process measures that will enable us to continually learn from the process of community participation and to report on our lessons learned. We will use both qualitative and quantitative methods to accomplish our aims. We believe that our proposal is stronger from our partnership with survivors and that our study is more likely to be successful because of community-based participatory research. PUBLIC HEALTH RELEVANCE: The goal of this R-21 application is to work with the cancer survivorship community to help improve their quality of life. Poverty, low literacy skills and rurality can lead to health disparities in cancer treatment, the ability to survive cancer and the quality of life after treatment is completed.